medical

As discussed in a previous post, there have been numerous false starts and failures in the implementation of secure text messaging platforms in the healthcare environment. The landscape is littered with expensive solutions that have seen low utilization, projects being shelved and as a result patient health information continuing to be shared via unsecured methods.

The primary reason for this situation is poor adoption by physicians and subsequently inconsistent use throughout the system. Poor adoption leads to overall poor utilization and a lot of wasted time, money and energy.

But physicians and care providers aren’t to blame. The blame falls on the technology itself. Few of the existing secure messaging products were designed to work with physician workflows and account for physicians need to control accessibility. Most physicians do not want others to have ‘open access’ to them, nor do they want to ‘sign in’ when they are available or remember to ‘sign out’ when they are not available.

While other technology vendors have provided public RFP templates for secure messaging, those templates focus primarily on the core functionality and the technical requirements of an individual product. They do little to highlight those functional features that will actually encourage broad physician adoption. So, while these templates are helpful, they do not necessarily help you achieve your goal of high user adoption.

With the goal of high user adoption in mind, here are seven key functionality questions you should include as part of your RFP for secure text messaging:

Does the technology automatically route certain types of messages to the physicians designated resource? This might be a resident, PA, fellow, or other clinical staff member. Physicians need control over their access and most solutions don’t offer a way to integrate these physician preferences into their applications.

How do physicians control their availability when they are not on call? Asking physicians to check in and check out every time they want to be unavailable is not a viable solution, and quite frankly, physicians won’t do it. Look for a solution with one time availability set up that accounts for call and clinical duties.

What happens when a message comes to a physician’s phone when they are in the middle of a procedure? This is one of the biggest complaints about secure messaging applications. The application should have an ability for scrub nurses or other providers in the OR to proxy into the physician’s account without having to access the phone. This allows timely response without the OR staff having to access doctor’s personal cell phone and pass words.

Does the platform allow for the user to identify and contact the patient’s current care team (including currently attending hospitalists and nursing staff) through one click access? Having to sift through the frequently long and comprehensive ‘care team’ listing in the EMR does little to facilitate fast, seamless interaction to those who are taking care of the patient at the moment.

Does the application integrate with call centers and other communication systems? Doctors don’t want to carry multiple devices. If secure texting is utilized as the primary method of contacting doctors (which increases adoption), the application needs to be integrated into the call center and function within the parameters of the call centers existing workflows

Does the application architecture and pricing allow for broad distribution to outpatient-based physicians, including regional referring doctors without running afoul of anti-kickback laws and incurring additional costs? Many current technologies offer ‘per head’ licensing, which a) limits the distribution of the product, limiting the overall adoption (see point above). Also, the technical architecture needs to ensure the application can be provided to these referring physicians without fear of giving something of value to these doctors.

Does the application integrate with nurse duty phones? Maximizing nurse/patient interactions is critical. If nurses have to use a desktop-based application, this reduces the available time for patient/nurse contact. Similar to the point above, if the system is to be charged for every downloaded application, adding the hospital-based nurses to the installation can be extremely expensive. Evaluators should look for a product that not only encourages broad distribution, but facilitates that through enterprise-based pricing and integrates with nurse duty phones to maximize patient contact.

The marriage between technology and physicians is not always an easy one and there have been a lot of bad breakups over the years. After all, physicians went to medical school to treat patients, change the world, etc. They did not set out to learn a new technology every time they turn around and/or to play a leading role in technology implementations. Yet today, they are finding themselves playing that role and feeling the frustrations that go along with that.

There is no shortage of research that talks about the challenges vendors face when it comes to technology adoption with physicians (and healthcare in general). Look no further than the EHR (electronic health record) technology market to learn more about those challenges and the lessons learned from them. In a 2015 study by Physicians Practice, physicians cite a long list of technology challenges (many of which relate to their experience with EHR technology), including: a drop in productivity when rolling out new technology; lack of interoperability between technologies; meeting regulatory requirements; cost to implement and use technology; resistance to technology; security and training.

MD Interconnect co-founder Dr. David Hoover was all too familiar with those challenges, having been on the user side (the resistance side may be more accurate) of numerous technology rollouts. He knew that MD Interconnect had to do things differently to ensure successful adoption.

With this in mind, the MD Interconnect team took a two-pronged approach to adoption. The first approach may seem obvious: design a product that solves a meaningful problem, but design it with your users (i.e. physicians, etc.) and their workflows (maybe not as obvious) in mind. Surprisingly, many technology companies develop a product that solves the first issue (meaningful problem) but neglect to consider the second (user workflows and preferences). Consequently, they experience poor adoption, limiting and or even eliminating the product’s ability to succeed.

The second approach is equally important but often overlooked – build an implementation process tailored to address a physician’s unique objections/concerns with an understanding of their job, their workflow, their practice, etc. With that in mind, you need to make it as easy as possible for them to get on board (hand-holding as needed), quickly demonstrate the value of using the technology (what’s in it for them), and ensure that they are motivated to continue using it (continued engagement, tracking, etc.).

When it comes to developing a secure communication solution for hospitals, there are some basic features and functionality that every solution must have at its core. The solution must successfully facilitate the delivery of messages between users. And, the solution must address mounting security requirements that hospitals face, including the need for HIPAA compliance. There are a number of vendors that offer products that address those core requirements, but MD Interconnect created a solution that goes beyond these basic requirements to engage users and ensure adoption. You can learn more about the company’s physician-driven design in this previous blog post. Here are some of the factors MD Interconnect considered while developing a product with adoption and sustained engagement in mind:

Physician adoption is of the highest priority. Lead with them and the rest will follow.

You must make it quick and easy for messages to be read, and provide visibility to senders about that status.

You must consider a physician’s personal preferences about when they should be reached and when they should not.

Call schedules and call hierarchies must be integrated into the communication platform.

It should also support the teaching hospital hierarchy and include residents, APPs, fellows and attendings at the appropriate times.

You must consider times when a physician cannot safely respond to a message, making it easy (and secure) for a proxy to respond on their behalf. See this blog post on RapidPair to learn more.

You must address the differences between cell phones and pagers, as well as the unique challenges, benefits, and behaviors associated with each.

The ability to easily forward a message chain to a support team, including clinic schedulers and bed management must be built into the solution.

With RapidConnect, MD Interconnect knew they had a great product that hospitals, physicians and patients would benefit from, but they also knew their job wasn’t done. See our next blog post on what it takes to ensure a successful implementation and ongoing user engagement.

In this interview with co-founder and Chief Medical Officer Dr. David Hoover, we share how his personal experience drove the creation of RapidConnect and how that experience sets this secure messaging solution apart from others in the healthcare market.

In 2014, David set out to respond to a critical challenge that physicians face, and one that he had experienced directly; connecting the right physicians at the right time, to ensure the best possible outcome for patients.

As a pediatric surgeon, David relies on physician referrals to connect with patients in need of his specialized services. He realized that outpatient-based physicians (pediatricians, internists, etc.) had a hard time reaching specialists (like him) based on a confusing list of various numbers and instructions depending on day of the week, time of day, secondary contacts (such as a PA) and other variables. It was frustrating to say the least and was far from efficient and/or effective.

To address the problem, hospital administrators would often add yet another 800 number and hire additional call center staff members to handle the calls. “This was obviously not a satisfactory solution to improving patient care in the long-term. I just knew there had to be a better way.”

David decided to take on the challenge directly, and began by researching existing solutions on the market. “I found a few available options, but none of them allowed users to create physician preferences based on how they wanted to be contacted and/or how they worked.” David knew the ideal solution would help users connect with the right provider at the right time, in a streamlined manner that worked for all parties involved.

David created MDInterconnect and worked with his software development team to prototype what he thought that solution should look like. He pulled from his own extensive healthcare experience and understanding of how physicians and hospitals operate. He also leveraged input from other physicians, hospital administration, call centers, etc. to address the nuances for both in-patient and outpatient providers. “We really gave thought to a number of possible scenarios and how we would account for each one in our software.”

“We were very in touch with what would make this work for physicians and knew that we needed to make the technology easily accessible and user friendly. Our flagship product, RapidConnect, was built on that philosophy and continues to evolve with that in mind.”

While other solutions are technology driven, RapidConnect is the only solution on the market that is truly physician driven. But, that is not the only thing that sets it apart. Secure messaging, call center components, ease-of-use, and delegation capabilities are just a few of the unique elements it has to offer. RapidConnect even offers built-in call scheduling functionality but also integrates with other industry-leading call scheduling solutions, such as Lightning Bolt.

David set out to improve communication between providers and to ensure the best possible patient care when they need it most.

“Better communication creates efficiencies around managing a patient’s care as well as the transition from one care setting to another. Treatments and meds are administered more quickly and effectively. The care team is engaged more collaboratively. The patient is managed more successfully. I wanted a solution that would lead to these outcomes.”